中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2012年
3期
193-196
,共4页
静脉血栓形成%导管消融术%支架
靜脈血栓形成%導管消融術%支架
정맥혈전형성%도관소융술%지가
Venous thrombosis%Catheter ablation%Stents
目的 总结经三种入路导管溶栓联合髂静脉介入治疗急性下肢深静脉血栓形成的疗效.方法 分析急性下肢深静脉血栓形成137例患者的临床资料,经小隐静脉置管溶栓107例,大隐静脉置管21例,胭静脉置管9例.对66例左髂静脉狭窄进行扩张,60例置入支架.结果 经小隐静脉置管的肢体消肿率为82.3％±7.6％,经大隐静脉置管为81.6％±6.0％,经胭静脉置管为83.9％±6.1％,3种入路间两两比较,差异无统计学意义(P＞0.05);溶栓率依次为63.5％±7.7％、66.9％±8.4％和66.1％±2.7％,3种入路间两两比较,差异无统计学意义(P＞0.05);3种入路置管平均耗时依次为(20.8±1.1) min、(7.3±0.3)min和(15.7±0.6)min,经大隐静脉置管耗时较短(P＜0.05).经小隐静脉置管有12例溶栓过程中并发切口出血,5例出现静脉炎,8例并发隐神经损伤;经胭静脉置管有2例并发术后腘窝血肿形成;经大隐静脉置管的并发症发生率较低(P＜0.05).随访112例,随访时间7～ 22个月,平均(10.1±1.5)个月.97例无患肢肿胀.经下肢深静脉造影或彩色多普勒检查,89例静脉通畅,8例血栓复发.结论 导管溶栓联合髂静脉介入是治疗急性下肢深静脉血栓形成的有效方法,经大隐静脉途径置管溶栓操作简单、术后并发症较少.
目的 總結經三種入路導管溶栓聯閤髂靜脈介入治療急性下肢深靜脈血栓形成的療效.方法 分析急性下肢深靜脈血栓形成137例患者的臨床資料,經小隱靜脈置管溶栓107例,大隱靜脈置管21例,胭靜脈置管9例.對66例左髂靜脈狹窄進行擴張,60例置入支架.結果 經小隱靜脈置管的肢體消腫率為82.3％±7.6％,經大隱靜脈置管為81.6％±6.0％,經胭靜脈置管為83.9％±6.1％,3種入路間兩兩比較,差異無統計學意義(P＞0.05);溶栓率依次為63.5％±7.7％、66.9％±8.4％和66.1％±2.7％,3種入路間兩兩比較,差異無統計學意義(P＞0.05);3種入路置管平均耗時依次為(20.8±1.1) min、(7.3±0.3)min和(15.7±0.6)min,經大隱靜脈置管耗時較短(P＜0.05).經小隱靜脈置管有12例溶栓過程中併髮切口齣血,5例齣現靜脈炎,8例併髮隱神經損傷;經胭靜脈置管有2例併髮術後腘窩血腫形成;經大隱靜脈置管的併髮癥髮生率較低(P＜0.05).隨訪112例,隨訪時間7～ 22箇月,平均(10.1±1.5)箇月.97例無患肢腫脹.經下肢深靜脈造影或綵色多普勒檢查,89例靜脈通暢,8例血栓複髮.結論 導管溶栓聯閤髂靜脈介入是治療急性下肢深靜脈血栓形成的有效方法,經大隱靜脈途徑置管溶栓操作簡單、術後併髮癥較少.
목적 총결경삼충입로도관용전연합가정맥개입치료급성하지심정맥혈전형성적료효.방법 분석급성하지심정맥혈전형성137례환자적림상자료,경소은정맥치관용전107례,대은정맥치관21례,연정맥치관9례.대66례좌가정맥협착진행확장,60례치입지가.결과 경소은정맥치관적지체소종솔위82.3％±7.6％,경대은정맥치관위81.6％±6.0％,경연정맥치관위83.9％±6.1％,3충입로간량량비교,차이무통계학의의(P＞0.05);용전솔의차위63.5％±7.7％、66.9％±8.4％화66.1％±2.7％,3충입로간량량비교,차이무통계학의의(P＞0.05);3충입로치관평균모시의차위(20.8±1.1) min、(7.3±0.3)min화(15.7±0.6)min,경대은정맥치관모시교단(P＜0.05).경소은정맥치관유12례용전과정중병발절구출혈,5례출현정맥염,8례병발은신경손상;경연정맥치관유2례병발술후객와혈종형성;경대은정맥치관적병발증발생솔교저(P＜0.05).수방112례,수방시간7～ 22개월,평균(10.1±1.5)개월.97례무환지종창.경하지심정맥조영혹채색다보륵검사,89례정맥통창,8례혈전복발.결론 도관용전연합가정맥개입시치료급성하지심정맥혈전형성적유효방법,경대은정맥도경치관용전조작간단、술후병발증교소.
Objective To evaluate catheter-directed thromlysis (CDT) through three different approaches in combination with intervention for acute deep venous thrombosis (DVT) of the lower extremities. Methods In this study 137 acute DVT cases were enrolled. CDT was performed through small saphenous veins in 107 cases,through the great saphenous veins in 21 and through popliteal veins in 9.Iliac vein balloon dilation was performed in 66 cases,and stents were placed in 60 cases. Results The limb edema reduction rates between small saphenous vein group and great saphenous vein group and popliteal vein group were of no significant difference (82.3％ ±7.6％ vs 81.6％ ±6.0％ vs 83.9％ ±6.1％,P＞0.05).The difference of rates of thrombolysis ( 63.5 ％ ± 7.7％ vs 66.9％ ± 8.4％ vs 66.1％ ± 2.7％ )between the 3 groups was not statistically significant (P ＞ 0.05 ). The mean time required for the cannulation was shorter in great saphenous vein group than the other two groups [ (7.3 ± 0.3 ) min vs (20.8 ± 1.1 ) min and (15.7 ±0.6) min,P ＜ 0.05 ].There were 12 cases complicating incision bleeding during thrombolysis in small saphenous vein group,in this group there were 5 cases complicating phlebitis and 8 complicating saphenous nerve injury.The complication rates in great saphenous vein group was lower (P ＜ 0.05).Follow-up made in 112 cases for 3 -25 months.There were 97 cases without limb edema.While test by venography or color Doppler,89 cases showed venous patency and rethrombosis developed in 8 cases. Conclusions Catheter-directed thrombolysis with iliac venous intervention was an effective method for the treatment of acute deep venous thrombosis.CDT through great saphenous vein is easier with less complications.
